Dark Was The Night One- Shot
by AJuneRose
Summary: A slightly AU one-shot re-imagining the ambulance accident from the episode 'Dark Was the Night'. Meredith's head injury is much more severe than it looks, and Alex suddenly has one more patient to save. Lots of Merlex friendship (LOVE!), some Mer/Cristina friendship, and of course MerDer. Rated T for language.


"Mer, get out of the rig!" He insists, "I'll stay with the baby."

"Alex, I'm not leaving you to die in this ambulance."

Frustrated, he moves to the captain chair behind the cab and fumbles for the safety belt, making a show of fastening it securely around his waist.

"Look, I'm belted in. I'll be fine. Now would you just go? Mer, please." His voice softens and suddenly he is pleading with me instead of yelling at me. "I can't be responsible for you losing your baby and your life. It's too much."

"Alex," I shoot back, "I'm not your responsibility. And I'll be no safer out in the middle of the damn road! You want to go? You go! I'm staying."

I know that Alex feels guilty for what he's done, and for how his actions have resulted in us losing Zola, and I'm truthfully still mad as hell at him for it. It's pushed me and Derek to an edge that I'm beginning to be afraid we won't be able to step back from. But in spite of everything, I love him. I need him. He's my family. My actions were my own, nobody forced me to slip Adele into the trial, and I won't let him play the martyr just to assuage his guilt. There's no way I'll be leaving him or that baby. He stares at me, jaw set in frustration, and I read the desperate emotion in his eyes that silently communicates that he feels the same way about me.

"Meredith..." he begins again, probably trying once more to convince me to get out, to run someplace relatively safer. But he doesn't get the chance to finish his sentence. The roar of the heavy rain pounding on the metal roof of the ambulance is deafening; we can hardly carry a conversation from 5 feet apart, and we never hear the approaching vehicle or the desperate squeal of its breaks as the driver tries too late to skid to a stop. Without warning, the sickening crunch of metal against metal rises above the noise of the storm and with a disorienting lurch the ambulance is suddenly moving again- skidding and spinning dangerously close to the steep edge of the narrow mountain road we're parked on. As my body is thrown forward like a rag doll, my forehead catches the edge of the bench across from me and searing pain suddenly explodes behind my eyes from the force of my temple making contact with cold steel. Time seems to move in slow motion, granting me the curse of watching oxygen tanks, defibrillators, portable cardiac monitors and other unsecured medical equipment become dangerous airborne missiles, like a scene from a bad action movie. I have just enough time to send a brief thank you to the universe that Alex left his seatbelt buckled while we argued. My eyes meet his for that one breath, just a moment, and his gaze reflects the shock and panic I know he must see in my own as well. Then time is racing forward again, and I come crashing down hard onto the unrelenting floor. I hear Alex's grunt as he's thrown viciously against his seatbelt, and my own guttural cry of pain, then the last sight I'm aware of before the world around me recedes into an empty rushing darkness is the incubator cradling the tiny body of the vulnerable newborn we're meant to be protecting toppling onto its side.

Derek's POV

Back in OR 3, the phone's dial tone echoes ominously in the stunned silence as everyone present tries not to imagine the worst, tries to convince themselves that it was simply a poor connection. Everyone except me. I know by the twisting, roiling dread coiled deep in my gut that the worst-case scenario is upon us, the ambulance has been hit. I hear Arizona and Mark as though I'm underwater, drowning in the ocean of my shock and panic and their voices sound muffled and distant, I can't make any sense of the words. For a moment I'm paralyzed with fear, unable to move, unable to speak, unable even to think clearly. My entire consciousness narrows to a single thought, a single word, a single name: _Meredith._

Jackson bursts into the room with an update, "The helicopter couldn't make it through the storm, so they're sending two more ambulances!"

And his question, "Are we still on speaker?" Is what shakes me from my shock. The world rushes back into focus and I am suddenly aware of the steadying pressure of Mark's hands on my shoulders, _breaking scrub,_ I note automatically, numbly; and then Arizona's concerned voice,

"...Derek? Can you hear me? Derek. Go with Mark, scrub out. We're almost done here, I can call Dr. Nelson to close."

I briefly consider staying and finishing the surgery, distracting myself from the horrible unknown; but when I glance down toward the patient I realize that my hand, still clutching the 10 blade in a death grip, is shaking violently. I let the scalpel and pickups I'm holding fall to the instrument tray with a clatter and force my eyes to meet Jackson's confused gaze.

"The ambulance was hit." I answer his question, still hanging in the air. "We lost contact."

My voice sounds strange to my own ears, hoarse and gravelly and tight with suppressed panic. The walls of the room that is usually my sanctuary seem to be closing in on me, crushing me between them until it's impossible to catch my breath. Suddenly, I desperately need to get out of the OR and fill my lungs with fresh air.

"Page Nelson to close," I tersely direct a wide-eyed intern, then I whirl around and plunge through the heavy door, ripping off my scrub cap and mask as I flee. I can barely hold my feet in place long enough to scrub out, and as soon as is sanitary, I'm jogging through the halls toward the exit, dodging surprised nurses and orderlies and ignoring the few doctors who turn to call after me in concern. When I emerge through the sliding doors of the ER entrance, gulping heady lungfuls of cold, night air, the adrenaline that has carried me out here fades and I slump exhausted against the stucco wall behind me. Running a still-trembling hand through my hair, I stare out at the rain in silence, mind and heart racing, not bothering to move or acknowledge Mark when he stumbles through the sliding doors a moment behind me, panting and out of breath, and comes to lean against the wall beside me. We stand for a few quiet moments until I break the silence with my ragged confession,

"I can't lose them, Mark."

Meredith is my light, my world. I hate that I was so upset with her when she left. I've been taking her for granted, I realize, pushing her away in my hurt when I know she's hurting too. I don't even remember telling her I loved her this morning, and now I might never get the chance again. And Zola... Our baby. Our chance at being a family. My heart feels split in two as I remember the social worker's call telling us that our court date was dismissed and suggesting that we move on. That phrase offended me, "move on". In our hearts, Zola had become ours, our daughter. We could never move on. My whisper sounds pleading, as if it's Mark that I'm trying to bargain with instead of an unsympathetic universe,

"I can't lose her and Zola both in the same day."

Mark's jaw works, and his eyes shine with emotion, but he doesn't offer any trite platitudes, doesn't insult me by brushing aside my fear and saying that everything will be ok. Instead he just stands there in the rain beside me, sharing some of the burden of my guilt and worry. And I am grateful not to be alone.

Meredith's POV

The first sensation I'm aware of as consciousness returns is pain. My head is a furnace, and every nerve seems to burn with white hot, blinding, unrelenting pain. The next sense I regain is smell; the choking, acrid odor of burnt rubber swirls around me, filling my nostrils and suffocating me. I cough, and the intense flare of pain that explodes through my skull is enough to make the darkness threaten again. For a moment, I am confused. My mind feels jumbled and slow and I can't remember where I am or what happened. Opening my eyes seems to take tremendous effort, so I lie there for another moment, gathering strength. When I finally do force my eyes open and push myself shakily up off my back onto my elbows, I see that I am sprawled out on the floor of the ambulance, which is half covered in spilled and broken medical supplies that have fallen from the shelves. Memory of the collision comes rushing back as I hear Alex's voice calling my name, sounding as shaken and uncertain as I feel.

"Mer? Meredith, are you ok?"

Still dazed, I move gingerly, testing each limb for injuries. My head throbs excruciatingly from its collision with the steel bench, every inch of my body feels battered and sore, and I'm certain I'll be covered in impressive bruises before the end of the day, but nothing seems broken.

"I think so. Are you?"

I croak out, using the edge of the bench behind me to haul myself slowly to my feet. I vaguely hear him replying, but a sudden wave of dizziness makes it impossible to focus on anything other than staying on my feet and my stomach churns, threatening to empty itself of everything I've eaten today. With a moan, I brace myself against the wall to stay upright, and inhale deeply to quell the rising nausea. Suddenly I feel Alex at my side; the strong arm he slides around my waist is a welcomed support while the world spins around me.

"Mer, tell me what's happening. Are you dizzy?"

I can hear the unmasked concern in his voice and I want to shrug him off and reassure him that I'm fine, but his body is warm and solid next to me and I can't stop myself from leaning into his steadiness, allowing him to anchor me while I wait for my balance to return.

"I'm fine," I say breathlessly once the frenetic motion of the room has slowed to a gentle rocking, "I just stood up too fast."

"Shit." I curse, stomach clenching with dread as my eyes fall on the isolet and I suddenly notice in horror that the unit holding Darcy's baby has fallen on its side, metal frame bent, on top of the pile of spilled supplies. I can just see the infant's head from where I stand, and it looks like her vent is still attached, but I'm not close enough to tell if it has been damaged by the impact of the collision or if she's still breathing. My mind begins to race with terrifying lists of potential injuries for unrestrained victims of a moving vehicle accident: internal bleeding, crush injuries, skull fractures, acute subdural hematomas, complex fractures, collapsed lungs, cardiac tamponade, aortic dissections... I need to move, she needs medical attention.

 _And so will whoever hit the_ rig, I suddenly remember. But as I take a panicked step toward the baby, Alex reaches out and catches my arm with one hand, stopping me so that he can gently lift my bangs off of my forehead with the other. When I turn questioningly toward him, his own forehead creases with worry and the fingers he reaches carefully up to my temple come away sticky with blood.

"Mer, you're bleeding." He informs me uneasily, "you shouldn't be working until I can check you out."

"I'm fine," I insist, ignoring the pounding pain that feels like a jackhammer inside my skull. "It's just a shallow laceration. The patient comes first, Alex, she needs us."

I brush his hands off and cross the floor in two strides, quickly dropping to my knees by the cracked isolet to assess the baby. Murmuring softly, I reach in for her tiny body, carefully lifting her out and cradling her in the crook of one arm.

"What are you doing?" Alex asks from behind me. "If you take her out, we can't regulate her temp!"

"She was just thrown around a plastic box, Alex. She needs to be held." I reply passionately, before turning my attention back to the baby. "Hey there, little one," I murmur. "What a bumpy ride you've had." I'm relieved to see her tiny chest still rising and falling, and to hear the ventilator miraculously still hissing. I notice a bump forming on her forehead and know that I should check her for signs of neuro injuries, but my thoughts are sluggish and jumbled and I can't seem to remember the first step.

"How is she?"

I'm relieved when Alex kneels beside me, and I hold the infant out for him to assess.

"She has a bump on her head," I point out quietly as I watch him begin to gently examine her for obvious injuries.

"Her pupils are equal and reactive, her pulse is rapid but steady, and abdomen is soft and flat, no signs of internal bleeding." He marvels. "Without imaging, we have no way of knowing if she sustained a brain injury, and that worries me. But it's a good sign that the bump is convex rather than indented." He finishes, rocking back onto his heels.

"You're a fighter, little one." I whisper, clutching her to my aching chest for a long moment as sudden exhaustion overwhelms me. I'm just beginning to let the hazy world around me fade when Alex materializes at my side, holding two emergency thermal blankets and an ambu- bag, making me jump in surprise. I hadn't even noticed he'd left.

"We have to get out of the rig, Mer." He rouses me by pressing the supplies into my free hand. "Just because we got lucky and the oxygen tanks didn't explode this time doesn't mean we won't go up like a Roman candle if we get hit again. Here- wrap her in these and detach the vent; you'll have to bag her. I'm going to go help the driver who hit us."

I watch him swing open the dented back door of the ambulance and jump out into the rain and shiver as a gust of cold, damp air rushes against my face.

"We're going to get you out of here, and you're going to be just fine." I soothe the baby, trying to convince fingers that feel oddly detached from my body to obey me. I manage to clumsily swaddle her in the two emergency thermal blankets to help keep her temp up, and I connect the ambu bag after frustratingly blanking for a moment on how to complete the simple procedure. The world around me spins violently again as I stumble back to my feet and I curse under my breath, reminding myself to keep bagging steadily, one squeeze per second. I'm reluctant to take the baby out into the heavy rain, she's premature and fragile and I know that there's something we should be worried about in her exposure to the cold and the elements, something to do with fluid and her lungs. But the word escapes me, flitting annoyingly out of reach of my floating, disjointed thoughts and it doesn't matter, really, because in the end Alex is right. We can't stay in here.

I step out into the rain and am instantly drenched, my hair plastered to my head and eyes squinting to see through the driving downpour. I do my best to shield the baby with my coat and my body as much as I can, as I look around for the wreck of the other car that hit us, and for the surely injured driver. This rural mountain road has no shoulder, and I gasp when I see how alarmingly close to the edge the ambulance has skidded. Another three feet and we would all be dead at the bottom of a steep ravine. It's impossible to see through the sheets of heavy rain more than a few feet ahead, and since I'm manually ventilating the baby I can't use my hand to shield my eyes.

"Alex!" I try to call out over the storm, but my voice comes out wispy and hoarse, so I try again.

"Alex!" This time I shout, and the effort sends a knife of such severe pain lancing through my skull that stars dance across my vision for a moment.

I stop walking to listen for Alex's response, but I realize my ears are ringing and I can't tell if he's answered me or not. When a strange red glow over the side of the hill catches my eye, I walk carefully toward it, until my toes brush the edge of the steep slope. The baby shivers in my arms and I clutch her tighter to me, hoping she can soak up some of my body heat. The smell of gasoline is heavy in the air, and when I look over the cliff and find Alex about 100 ft below me, staring at the source of the light, I understand why. A mangled car rests upside down at the bottom of the ravine, burning even in the heavy rain _._

 _The driver who hit us_ , I think, horrified. There was no way anyone in that vehicle had survived.

"Alex!" I shriek, and he turns toward me, the flames casting eerily shifting shadows over his face. He must have gone down to try to help, but just below where he'd found a precarious foothold, I see the steep slope of the hill turn into a straight drop of at least 1000 feet. He can't get any closer without rescue equipment our basic ambulance doesn't carry, and I'm ashamed of my selfish relief. I don't step back from the edge until I see him begin to climb back up, and when he hoists himself up onto the road, soaked and covered in mud, neither of us speak for a few moments. We just stand in solemn silence while the light from the fire plays across our faces. Until Alex says absently,

"We need to call search and rescue. They'll have the equipment to get down there and..." He trails off and shoves a hand into his pocket, looking for his cell phone. "Damn it, it's gone." He says, then turns to me. "Mer, do you still have yours?"

I stare at him blankly for a moment, not sure why his words are suddenly just strange disjointed bursts of sound that make no sense to me. Eventually I manage to say numbly, "What?" I'm exhausted and my stomach is in rebellion again and my head feels like it might explode. I almost wish it would, over the last 10 minutes, the painful pressure has become nearly unbearable.

"Your phone, Mer." He repeats, louder this time, as though thinking I simply couldn't hear him over the rain. When I still don't move or respond, he leans in closer to me and reaches his hand inside the pockets of my jacket and scrub pants, triumphantly emerging with my phone. He presses the home button and checks the service, but I can tell from the way his hopeful expression crashes into anger that I don't have any bars. With a grunt of frustration, he swipes one dirty hand across his face, leaving streaks of mud behind. "No service. How long has it been? 10 minutes? 15? If someone was able to call it in, another unit should be here by now. We didn't make it that far up this damned mountain."

I barely hear him. It's getting harder and harder to keep squeezing the bag consistently because my hand feels slow and cumbersome, disconnected from my body. Hot, stinging bile slowly inches its way up my throat and I need him to take the baby, I need him to take over ventilating before I vomit all over her.

"Take her," I gasp, uncovering the baby from my jacket and shoving her at Alex.

I hold the sickness back until he has her little body tucked safely against his and has begun squeezing the ambu bag, and then I'm choking and gasping and vomiting all over myself. I feel the steady heat radiating from Alex's body even in this cold rain as he moves closer to me, and though he doesn't have a free hand to hold back my hair like he's done after a night of one too many at joes, I hear him comfort me softly with his voice,

"Ok, Mer. It's ok, you're ok."

When my stomach finally finishes emptying itself of everything I've eaten today, I collapse in a trembling heap onto the muddy ground. My scrubs are soiled, and I smell like sick, but I can't bring myself to care. The world has resumed its wild spinning and I moan miserably.

"Mer? Hey Meredith, can you look at me?" Alex is crouched awkwardly in front of me, brow furrowed in open worry, still rhythmically squeezing the bag that's breathing for the baby. With effort, I lift my pounding head and force my eyes to meet his. Even though he's only inches from my face, his features look blurry and vague. I flinch in pain and squeeze my eyes shut when he holds up my phone and shines its flashlight into my face. "Mer, listen. I want to check your pupils, ok? I need you to open your eyes for me." His voice is mostly calm, carefully controlled, but I know Alex as well as I know myself. I can hear the slight waver of the fear he thinks he's hiding, and it scares me too.

"Wash wong wit mmme?" I try to ask what he's looking for, what he thinks is wrong with me, but my words come out slow and slurred and my lips feel thick and unwieldy. I hear his sharp intake of breath, and he doesn't disguise the urgency in his voice this time when he barks at me,

"Meredith! Open your eyes, focus on my face." I obey for as long as I can, even though the bright light he immediately turns on me again is a stabbing sword of pain behind my eyes. The wave of nausea that had briefly receded swells again and I turn away from his dismayed gaze to vomit up bile until my throat burns and my eyes water. When I'm finally done dry heaving, the rushing in my ears is back and Alex's alarmed voice sounds far away. The throb of torturous pain in my head is overwhelming, and I'm grateful when I finally escape into merciful unconsciousness again.

Alex POV

"Mer? Hey Meredith, can you look at me?"

She's acting really out of it, and the relief I felt initially that she was ok is rapidly turning into a weight of worry and doubt that settles like a stone- cold and heavy in the pit of my stomach. I try to keep my voice calm and steady, but even with my best efforts the words still come out shaky, and a little higher pitched than normal. Mer is covered in vomit, and the smell turns my stomach, but I inch closer anyway. She could just be upset by the crash and the horrible death we've just witnessed, but doubt freezes my veins because I know that's unlikely. She's a surgeon, she deals with these kinds of traumas regularly. My mind races, trying to think back through the chaotic minutes since the crash and catalog any symptoms I may have missed. She was dizzy, and the thin trail of dried blood from her cut catches my eye as I watch her, shining against her cheek as she rests with her head against her knees. The laceration means she hit her head against something, and head trauma coupled with vertigo and nausea and now this scary semi- responsiveness... Her symptoms are consistent with a severe concussion, I realize. And without imaging, there could be an undiagnosed subdural hematoma. If it was acute, and had been bleeding this whole time, the pressure in her skull by now would be reaching dangerous levels.

I feel the blood drain from my cheeks and my hand on the ambu bag trembles, but not from the cold. _I need to do a neuro check,_ I think desperately. There are no street lights along this rural road, and I'm not willing to risk leaving her out here alone to run back into the ambulance for a light. Instead, I grab for her iPhone again, punch in the password she hasn't changed since intern year and swipe up to access the flashlight. When she lifts her head to look at me, her face is pinched with pain and I feel a stab of horrible guilt for not noticing earlier in the midst of the chaos that she really wasn't fine. I shine the light into her eyes, hoping to check her pupils for equal size and dilation, but she sucks in a strangled breath and averts her eyes before I can get a clear look. I hear her mumble something, but she sounds drunk, her words come out thick and slurred. The worry I've been doing my best to suppress until now flares up inside me in a flash of cold terror, and I don't try to check it this time. Urgency makes my tone harsh and commanding when I direct her to look at me again.

"Meredith! Open your eyes. Focus on my face!" And when she does, my world stops for a moment. Her pupils are unequal, and one is not reacting to the light at all.

"Dammit!" I curse under my breath. "Oh God, Mer, I'm sorry. I'm so sorry. This is my fault. I should have forced you to sit still and let me assess you. I should have forced you to get out of the freaking rig in the first place!"

She's been watching me rant with a glassy, uncomprehending stare until now, but when I pause for breath her eyes suddenly roll back into her head and her body slumps lifelessly to the side. My hand shoots out reflexively, barely managing to catch her head before it can hit the asphalt and do secondary damage. A sob catches in my throat as I quickly check for her pulse and then withdraw my hand, returning to the steady rhythm of breathing for the baby. I want nothing more than to pick her up off of the cold, wet asphalt and cradle her head in my arms instead. But Meredith would agree that the patient comes first, and so I ventilate. I settle for talking to her, hoping that if she can hear me even on a subconscious level that my voice might reassure her.

"It's ok, Mer. I'm right here, I'm going to get us out of here."

She's unresponsive, but the soothing tone I'm using for her seems to be helping me hold it together, so I continue murmuring softly as I awkwardly switch the infant in my arm to an uncomfortable football hold so that I can both support and ventilate her with one hand. With the other I switch on the phone flashlight again, hold it in my mouth, and reach out to gently retract Meredith's eyelids one at a time. Her left pupil has blown, and I curse colorfully and loudly. She needs a CT scan and surgery, but I don't have that luxury here. I bite off an animalistic growl of frustration as my mind scrambles frantically for alternatives. _A burr hole_ , I decide with a chill of dread. Since the intracranial pressure has increased to a level sufficient to cause her pupil to blow, a burr hole is indicated. I'll have to leave her alone and exposed here in the middle of the road and risk reentering the unstable ambulance to find a drill, but it's that or she dies, and I refuse to even entertain the latter as a possibility.

"Meredith, listen, you're doing great. I'll be right back, everything's going to be fine!"

I throw one last reassurance over my shoulder before sprinting back into the ambulance, hoping desperately that the universe doesn't make me into a liar. I'm once again holding and ventilating the baby with one arm and my shoulder burns with strain, but I ignore it, bending down to paw desperately through the mounds of loose supplies strewn all around me, almost dizzy with relief when I catch a glimpse of a familiar handle and pull an undamaged bone drill out from beneath a pile of no longer sterile gauze and surgical gloves. A little more digging uncovers a miraculously still packaged scalpel, and I somehow maintain the presence of mind to grab an alcohol wipe and some of the gauze and gloves as well. In two heartbeats I'm back at Mer's side again, steadying her head between my knees. I switch on the phone flashlight, holding it in my mouth while I pull on a glove and place three shaking fingers above her ear, and then three fingers more in front of that on the side with the blown pupil, her left side.

"Ok Mer, here we go." I use the blade to make a vertical scalp incision down to the skull at the point my fingers marked. Hot red blood pours over my hand and down her face, soaking her hair and her scrub top and I want to panic.

"Just superficial bleeders," I remind myself, sending a desperate plea out to God or the universe or whoever else might be listening that I don't screw this up and kill my best friend. Then I swipe the alcohol wipe over the top of the bone drill and carefully lower it to make contact with the temporal bone that I've exposed, drilling a hole in the middle of the wide incision. The temporal bone is only a couple of millimeters thick, and I'm more terrified than I've ever been in my life that I'll drill too far and puncture the dura. But then I feel the drill give and I know I'm in. I lean forward to shine the light into the hole and see blood. So I once again touch drill to glistening bone, driven by desperation and fear. I have to expand the opening. I have to relieve the pressure. When the hole I've created is roughly two centimeters wide, I set down the drill and reach in with one gloved, shaking finger to evacuate as much of the large clot of blood as I can. When I've removed as much as I'm able to without suction, I lean in again to examine the area. I see lots of clots, but no arterial bleeds; which I shakily remind myself is a good sign. The dura, which I mercifully haven't punctured, also looks healthy, pulsating regularly with her heartbeat. I sigh in relief, trembling with adrenaline.

"That's good," I breathe. That means her brain is receiving blood and oxygen again. "That's good, Mer."

I pack the gaping wound with gauze to minimize bleeding and sit back to catch my breath. I feel winded, like I've just run a marathon. I've done everything I can for now, but what she needs is an emergency craniotomy. She needs to get out of here, we all do.

Head lights in the distance suddenly draw my attention and my heart leaps into my throat. Mer is lying in the middle of the road, and I can't move her and still ventilate the baby. Without thinking, I sprint a few hundred feet down the slope, toward the approaching vehicle and plant myself in the middle of the road, heart pounding. When the vehicle gets close enough for me to hear above the rain I throw one arm above my head and wave it wildly through the air, yelling "Stop! Stop the car!"

I truly think I might die for one petrifying second, and then the driver sees me and slams on his breaks, skidding slightly across the wet asphalt before coming to a screeching stop much too close to me for comfort. He switches off the headlights that are blinding me, and yells urgently out his window,

"Are you Alex?"

When my vision finally returns, and I can see the vehicle I've flagged down, I almost collapse in relief. It's an ambulance; Derek or Mark or Arizona had been able to get EMS to dispatch another unit after all.

"Yes! Yes, I'm Dr. Karev. You need to call, to radio Emergency services, or search and rescue, or someone. The car that hit us and its driver went off the side of the cliff."

I gesture up the road toward the faint glow cast by the still burning wreck and am grateful to see the EMT in the passenger seat of the rig immediately grab for his comm unit.

" I also have a premature infant here who is on a manual vent and can't regulate her temp, she needs to get out of this rain and she needs to be scanned for head trauma." The driver jumps out and rushes around the rig to me as if to take the baby, but I clutch her more tightly.

"My co-worker, Dr. Grey. She's about 100 ft up the slope. She was exhibiting symptoms of an acute subdural hematoma, she lost consciousness and I performed an emergency burr hole to relieve some of the intracranial pressure. She's still unresponsive, she needs an emergency craniotomy!"

As I'm rattling off statuses, I hear sirens and see another ambulance slowly pull up behind the first. The EMT who first addressed me reaches slowly toward me again, like I'm a wild animal he's trying not to startle, and eases the baby from my arms, seamlessly taking over the rhythm of my bagging.

"I've got her now, Dr. Karev." He reassures me. "We'll take good care of her."

"Seattle Grace!" I burst out as the absence of her slight weight leaves my arms feeling empty, and the EMT looks at me quizzically.

"She's my patient, please. I want her taken to Seattle Grace Hospital." I repeat more calmly. He nods, already jogging toward the open doors of his rig, where I catch a glimpse of specialized pediatric intensive care equipment waiting and feel an enormous weight lift from my shoulders.

"I'm Ray," the driver of the second ambulance introduces himself, and I realize he has been waiting beside me, listening as I informed the first EMT of Mer's condition. "My partner, Joel, is grabbing a c spine brace and a stretcher. Take me to your friend."

He doesn't have to ask me twice. I sprint back up the hill, ignoring the ache in my legs and the burning in my chest, relieved to finally have help and supplies and desperate to get back to Mer. She hasn't moved from the position I left her in, and I drop to my knees next to her, finally free to assess her properly. Ray is a few steps behind me, and when he reaches us, I've already prepared her for the c spine brace. As soon as he sets down his bag, I open it without waiting for permission or sparing a thought for protocols of jurisdiction, prepared to bite his head off if he tries to tell me to stay out of the way. It's a credit to his common sense that he wisely doesn't say a word when I grab his stethoscope and check Meredith's chest for equal breath sounds. We work together in easy tandem, which expedites his assessment, and I'm so grateful that her vital signs have remained steady I could cry. It seems like an eternity before I see Ray's partner-Joel, I think- finally materialize out of the rain with the stretcher, although I know logically that it could only have been a couple of minutes at most. When he reaches us, I grab the stabilizer that he extends toward Ray and gently lift Mer's head to slide the brace around her neck. Lifting her tangled hair carefully out of the way, I fasten the brace in the front and then move around behind her to grab hold of her shoulders.

"You ready?" I ask, glancing up at Joel, who wisely takes his cue from Ray and simply nods in answer to my question before positioning himself at her feet. "On three," I direct. "I, 2, 3!"

She's so much lighter than I expected, and with the two of us it takes almost no effort to transfer her smoothly to the waiting backboard. For some reason, this is what breaks my carefully maintained calm: how small and fragile she feels in my arms. I can almost feel the adrenaline that has been pumping through my body, filling it with reserves of energy since the crash seep out of my veins, leaving me trembling and spent. Joel pauses to reach out and brush my shoulder in a show of camaraderie before he and Ray stride briskly past me, carrying Meredith to the waiting ambulance.

"Dr. Karev, you can ride in the back with your friend. I need to get as much of her medical history from you as you're able to give me and I'd like to check you out for injuries as well."

I want to tell him that I'm fine, I'm not injured, and he should focus on Mer. But it takes a moment to convince my feet to move again, and I think detachedly that I might be in shock. Eventually, I follow them down the hill, climbing into the back of the rig and perching on the edge of the bench beside Meredith's limp body.

"I'm right here, Mer," I whisper, against her wet, bloody hair. "I'm right here."

The rig carrying the infant has already left and I take Meredith's small, cold hand in both of mine, unwilling to let go as our ambulance follows it, speeding back down the hill through the night.

Meredith POV

The next time I open my eyes, I'm in an ambulance, strapped to a backboard. I hear voices overlapping indistinctly around me, but none of them are Alex's. Someone's hands lift my arm to feel my pulse and take my blood pressure, and the touch is sure and competent but clinical and unfamiliar and I feel anxious and untethered without Alex. They must notice that I'm awake because I'm welcomed back to reality by a burning light shining into my eyes, which is what I blame the tears on when they start to fall.

"Ma'am you were in an accident. We're taking you to the hospital, can you tell me your name?"

"It's Dr." I correct with a moan. "Alex?" I ask, and when he doesn't immediately answer, I'm terrified that something has happened to him while I was out. Images of him strapped to his own backboard fill my mind and I whimper.

"Is Alex Dr. Karev?" The paramedic hovering over me asks kindly, "The one with the baby?" Through my tears I try to nod before realizing I'm wearing a neck brace and my forehead is strapped to the board, immobilizing me.

The paramedic steps back out of my line of vision and I hear him murmur, "Hey man, wake up. She's asking for you."

Then, in the space of only a second, Alex's face appears above me where the paramedic had been. He looks wrecked; eyes bleary and bloodshot, face still streaked with mud, and there's a deep line imprinted in one cheek, like he'd fallen asleep leaning against something very uncomfortable and had only just awakened. But even still, a whimper of relief escapes my throat at the sight of him.

"Hey. Hey, Mer," he breathes, and I watch his Adam's apple bob violently up and down as his concerned gaze searches my face, my body, automatically assessing my condition. I realize that he's been holding my hand delicately in both of his own this whole time, as though I'm made of glass and he's terrified that one good squeeze will shatter me. I want to tell him how glad I am to see him; how grateful I am that he's here and ok. And I want to ask about the baby, what happened while I was unconscious. But every bump on the road is sending piercing knives of pain stabbing through my head and though I try to be strong, I can't choke back my sobs any longer. Alex's grip tightens minutely at my tears and his thumb rubs soothing circles on the back of my hand even as he snaps at the paramedic,

"Didn't you give her any morphine while I was out?"

I hear the man defensively reply, "5ccs", and if I weren't so busy drowning in my agony I might feel sorry for him when Alex barks in response,

"Well, she's sobbing in pain so it's clearly not enough! Push 10 more, now!" Fingers fiddle with something in the crook of my arm, and I'm suddenly aware that I have an Iv.

"Shhh Mer, shhhh." I hear Alex hush soothingly. "I'm so sorry. You're doing great, you're doing so great. Ray's pushing more morphine, ok? You'll feel much better in just a minute."

I feel it the second the drugs hit my veins, running cold into my arm. Immediately, the crushing pain is dulled and then gone all together, and my body feels light and floaty. The world seems liquid, shifting and oozing oddly around me and sounds seem distant and muffled. I sigh deeply and let myself float away from reality again.

The next time awareness slowly filters through my oblivion it brings no pain with it, only confusion. For a long moment I lie there blankly, suspended between waking and sleeping, waiting for my mind to assemble its scattered thoughts and remind me what has happened. Memories come floating back in bits and pieces: transporting Darcy's baby, the engine in the rig dying, the crash... Everything goes fuzzy around the edges after the crash, but I think I remember Alex's concerned face hovering over me, the hard plastic of a backboard strapped to my body, and pain- constant, blinding pain. Slowly, I notice the familiar beeping of monitors, and realize that the rigid backboard has given way to the sterile softness of a hospital bed. I know that I was injured and now I'm in a hospital, but I'm still disoriented, and it takes conscious effort not to panic at not knowing where I am or what day it is or what exactly has happened to me. I focus on taking deep, even breaths, and gradually calm myself enough to notice something warm and soft curled against my left side. The slight pressure against my body comforts me, somehow grounding in the midst of my confusion. When after a few moments of gathering strength, I manage to turn my head in that direction, something that feels like hair brushes my nose, leaving it itchy. My eyes creak open, heavy and slow under the weight of exhaustion and whatever drugs I'm on and when my blurry vision finally clears, I'm staring down at a tangled waterfall of familiar dark curls _._

 _Cristina_.

She's squeezed herself uncomfortably into the tight space between my body and the rail of the narrow bed, her warm fingers intertwined with my cold ones and her head pillowed on my shoulder as she sleeps. My disorientation and fear fade with her presence and I feel tension I wasn't aware of seeping from my muscles. I let my gaze continue slowly around the room and realize that I recognize the placement of the bed, the colors of the walls, the purpose of each of the machines and equipment surrounding me; I'm in the Neuro wing of Seattle Grace's ICU. A rumbling exhale abruptly draws my attention, loud in the stillness of the room, and I notice Alex sprawled in a plastic chair that's been tugged up close to my bed. He's slumped forward onto my legs and snoring, his face only inches from Cristina's sneakers. A weary smile stretches across my face, and my body relaxes, sinking further into the mattress.

 _My family is here_.

Only one person is missing, and when a gentle hand surprises me, reaching up to tenderly cup my right cheek I know who it is even before I can convince my head to turn that way and stare into endless blue eyes.

"Derek" I murmur into his palm, breathing in the heady combination of hospital antiseptic soap, and spicy cologne and musk that is uniquely, intoxicatingly him.

"Meredith," he whispers back at me, voice full of emotion and soft so as not to wake my sleeping friends. The hand on my cheek stays there, caressing me gently and my free hand is suddenly swallowed up in his warm, steady grip.

"What..." I croak out and he knows what I'm asking even though the words get stuck in my dry throat. He holds a cup with a bendy straw to my lips and I take grateful gulps of the lukewarm water.

"You sustained injuries in the collision," he informs me softly. "Acute subdural hematoma." My eyes widen as I digest this information. My mind still feels slightly sluggish from the drugs, but I vaguely recall hitting my head on the bench and my symptoms after the crash and realize that this diagnosis makes sense. "Alex performed a burr hole on the scene…" Derek's gentle voice continues, and I pull my drifting mind back to the present to focus on his words. "…To relieve some dangerous pressure, and three days ago you had an emergency craniotomy. It was some of my best work." He smiles shakily at me, but I clearly read the terror and the pain and worry in his gaze that even his obvious relief that I'm awake and mentally intact can't quite hide.

"The baby?" I immediately question, and then as his words sink in, "3 days...?" I trail off, stunned, and again he anticipates my questions before I can ask them.

"The baby is fine, she's up in the NICU right now. She had a slight concussion and a mild skull fracture, but miraculously no other damage. You and Alex saved her life. And yes, three days. The rig brought you in late Wednesday night and right now it's 2:00 am on Sunday morning. You really scared us; your body was under a lot of stress and the longer it took the more I thought, maybe..." His jaw works, and he glances away from me in shame as tears well up in his eyes, threatening to spill over.

"Meredith, I'm so sorry." He confesses in a tortured whisper that breaks my heart and makes me ache to reach out and hold him, to take away his pain like just his presence is taking away mine.

"I was an ass and an idiot to be angry with you- about the trial, and Zola, and this whole stupid, pointless fight... I pushed you away and I've had more time than I knew what to do with over these past few days to realize over and over again that what I should have done is pull you close. I should have pulled you close and never let go. I love you, Meredith. I love you. You're my entire world and I'm so, so sorry." He's crying in earnest now and I realize my own tears are running down my cheeks as well, dripping steadily off my chin and dampening Cristina's hair. But she doesn't stir, and I can't stop anyway.

"Derek," I murmur. He stops me, cutting my sentence short with his lips, sending the words I was going to say flying out of my brain. His kiss is warm and soft and desperate; it tastes of salty tears and apologies and promises. The instant hangs, suspended by a breath, and I never want it to end. But when we finally pull apart, my eyes droop with sudden exhaustion. I try to force them back open, to stay here with Derek in the warmth of this moment, but he notices my fatigue and brushes a tender hand across my forehead.

"It's ok, rest now." His soft voice is soothing, and it reassures me. "Heal. I'll be here when you wake up."

Cristina sighs in her sleep, her warm breath puffing softly against my neck. My eyes slip closed; lulled by the gentle circles Derek's thumb traces on the back of my hand, and solid warmth of my family surrounding me. Just before I surrender to the tide of painkillers and exhaustion that wants to pull me along with it back into sleep, I realize that I'm irrationally happy. Somehow, lying here in this hospital bed post emergency craniotomy- despite my mother's death, despite the crash, despite this setback with Zola, despite everything- for the first time in a long time, I'm happy. And I'm somehow hopeful that as trite as it sounds, and as skeptical as I've been, maybe for the first time in my life everything will turn out ok. My last conscious thought before I lose the struggle and sleep pulls me under is the cautious hope that maybe, just maybe, there's enough happy for everyone. Even Meredith Grey.


End file.
